Workers’ Compensation · Primary-source case analysis

Cervantes: Spinal-Surgery Objections Required Timely Utilization Review

By Aneeta Mishra and Timothy Chan

Published May 3, 2026

Cervantes coordinated the utilization-review and spinal-surgery second-opinion procedures that applied to a treating physician's recommendation under the statutory and regulatory scheme then in force.

The dispute concerned overlapping procedures

The treating physician recommended spinal surgery, and the parties disagreed about whether the defense could bypass utilization review or delay the separate objection required to invoke a second-opinion process. The WCAB addressed the sequence and deadlines en banc to secure uniform administration.

Utilization review came first

The Board held that the defendant had to undertake utilization review. Approval—or failure to complete utilization review on time—required authorization under the framework then governing. A denial could be followed by an objection under former section 4062(b), but the objection had to use the prescribed form and procedure.

The ten-day period governed both steps

The defendant had to complete utilization review within ten days after receiving a compliant treating-physician report and, if review denied surgery, make the statutory objection within that same period. Missing the time or form requirements forfeited the second-opinion route and required authorization.

Current disputes require current-law analysis

Cervantes disapproved earlier guidance allowing a defendant to opt out of utilization review. Later legislation and regulations materially changed treatment-review procedures, including independent medical review. The opinion is important procedural history, but a present dispute must be mapped to the statutes and rules effective on the treatment request date.

Key takeaways

• Identify the law in force when the treatment request arose.
• Track receipt, utilization-review, and objection dates precisely.
• Use the required form and procedure for the applicable review system.
• Do not apply Cervantes's former ten-day framework without checking later amendments.